Eccles M, Bradshaw C
Centre for Health Services Research, University of Newcastle upon Tyne.
BMJ. 1991 Jan 12;302(6768):91-2. doi: 10.1136/bmj.302.6768.91.
To record the use of secondary prophylactic drugs in patients discharged from hospital having had a myocardial infarction.
Prospective postal questionnaire survey of a random one in two sample of general practitioners in the region.
The nine family practitioner committee areas within the Northern Regional Health Authority.
Patients who had had a myocardial infarction and were discharged to their general practitioner.
Whether beta blockers or aspirin, or both, were given on discharge.
Of 267 patients, 158 (59%) were treated suboptimally in that they did not receive a secondary prophylactic drug to which they had no contraindication. For most patients this entailed underuse of one drug, but 17 (6%) of patients received no treatment. beta Blockers were 2.5 times less likely to be used than aspirin. Treatment was not associated with the age or sex of the patient, risk of further infarction, or hospital of discharge.
Secondary prophylaxis after myocardial infarction is practised haphazardly. It should be offered to all patients who can tolerate it, after a trial period to assess any side effects of the drugs if necessary.
记录心肌梗死出院患者二级预防药物的使用情况。
对该地区二分之一的全科医生进行随机抽样的前瞻性邮寄问卷调查。
北部地区卫生局下属的9个家庭医生委员会区域。
发生过心肌梗死且已出院至其全科医生处的患者。
出院时是否给予β受体阻滞剂或阿司匹林，或两者都给予。
在267例患者中，158例（59%）治疗不充分，即未接受无禁忌证的二级预防药物治疗。对大多数患者来说，这意味着一种药物使用不足，但有17例（6%）患者未接受任何治疗。β受体阻滞剂的使用可能性比阿司匹林低2.5倍。治疗与患者的年龄、性别、再次梗死风险或出院医院无关。
心肌梗死后的二级预防实施得很随意。对于所有能够耐受的患者，应在必要时经过试用期以评估药物的任何副作用后提供二级预防。
